Texas Register April 17, 2020 Volume: 45 Number: 16

Texas Register Table of Contents

Texas Department of State Health Services

 

Emergency Rule

New 25 TAC §133.51, restricting hospital entry and requiring screening of certain authorized hospital personnel

CHAPTER 133. HOSPITAL LICENSINGSUBCHAPTER C. OPERATIONAL REQUIREMENTS25 TAC §133.51OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 25, Texas Administrative Code, Chapter 133 Hospital Licensing, new §133.51, concerning an emergency rule in response to COVID-19, in order to reduce the risk of transmission of COVID-19. To protect patients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to restrict entry into a hospital and require screening of certain persons authorized to enter a hospital.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Hospital Response to COVID-19.As authorized by Government Code, §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code§2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §500.2, allowing certain hospitals to waive the requirement that off-site facilities be open or licensed within the past 36 months

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER A. HOSPITALS26 TAC §500.2OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 500, COVID-19 Emergency Health Care Facility Licensing, Subchapter A, Hospitals, new §500.2 (Waiver of 36-Month Requirement in Response to COVID-19), concerning an emergency rule in response to COVID-19 to allow HHSC flexibility in implementation of an emergency rule adopted at 26 Texas Administrative Code, §500.1 related to off-site facility licensure.To protect current and future patients in health care facilities and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC previously adopted an emergency rule to allow a currently licensed hospital to operate an off-site inpatient facility. To allow operation of additional off-site facilities, HHSC is adopting this emergency rule to allow licensed hospitals to request a waiver of the requirement that off-site facilities be open or licensed within the past 36 months, at the Commission’s discretion.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for hospital off-site facilities in response to COVID-19.As authorized by Government Code §2001.034 the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §510.48, restricting entry and requiring screening of certain authorized personnel at private psychiatric hospitals and crisis stabilization units

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITSSUBCHAPTER C. OPERATIONAL REQUIREMENTS26 TAC §510.48OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 510, Private Psychiatric Hospitals and Crisis Stabilization Units, new §510.48, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19.To protect patients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to restrict entry into a facility and require screening of certain persons authorized to enter a facility.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Facility Response to COVID-19.As authorized by Government Code §2001.034 the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §500.20, allowing certain End Stage Renal Disease facilities to operate an off-site outpatient facility without obtaining a new license

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER B. END STAGE RENAL DISEASE FACILITIES26 TAC §500.20OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis new §500.20, ESRD Off-Site Facilities in Response to COVID-19, in Texas Administrative Code (TAC), Title 26, Chapter 500, Subchapter B, concerning an emergency rule to allow end stage renal disease (ESRD) facilities to treat and train dialysis patients more effectively in response to COVID-19.To protect current and future patients in health care facilities and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to allow a currently licensed ESRD to operate an off-site outpatient facility without obtaining a new license at: (1) an ESRD that is no longer licensed that closed within the past 36 months; (2) a mobile, transportable, or relocatable medical unit; (3) a physician’s office; or (4) an ambulatory surgical center or freestanding emergency medical care facility that is no longer licensed that closed within the past 36 months.BACKGROUND AND JUSTIFICATIONThe purpose of the new emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state exists and requires immediate adoption of this new rule to ensure that dialysis patients receive safe treatment.As authorized by Government Code §2001.034, the Executive Commissioner may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §551.401, restricting entry and requiring screening of certain authorized personnel at intermediate care facilities for individuals with intellectual disabilities

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONSSUBCHAPTER M. COVID-19 EMERGENCY RULE26 TAC §551.401OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 551 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition, new §551.401, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect residents of intermediate care facilities and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to restrict entry into an intermediate care facility and require screening of certain persons authorized to enter an intermediate care facility.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Intermediate Care Facility Response to COVID-19.As authorized by Government Code §2001.034 the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §553.45, restricting entry and requiring screening of certain authorized personnel at assisted living facilities

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIESSUBCHAPTER C. STANDARDS FOR LICENSURE26 TAC §553.45OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 553 Licensing Standards for Assisted Living Facilities, new §553.45, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect residents of assisted living facilities and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to restrict entry into an assisted living facility and require screening of certain persons authorized to enter an assisted living facility.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Assisted Living Facility Response to COVID-19.As authorized by Government Code §2001.034 the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §558.408, requiring screening of staff, clients, and household members in connection with home and community support services

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER D. ADDITIONAL STANDARDS SPECIFIC TO LICENSE CATEGORY AND SPECIFIC TO SPECIAL SERVICES26 TAC §558.408OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 558 Licensing Standards for Home and Community Support Services Agencies, new §558.408, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect clients served by home and community support services agencies and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to require screening of staff, clients, and household members and offer alternative methods to provide non-essential services.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for HCSSA Response to COVID-19.As authorized by Government Code §2001.034 the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §558.872, restricting entry and requiring screening of certain authorized personnel at inpatient hospice units

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 7. HOSPICE INPATIENT UNITS26 TAC §558.872OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 558, Licensing Standards for Home and Community Support Services Agencies, new §558.872, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect clients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to restrict entry into an inpatient hospice unit and require screening of certain persons authorized to enter an inpatient hospice unit.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Hospice Inpatient Unit Response to COVID-19.As authorized by Government Code §2001.034 the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Department on Aging and Disability Services

Emergency Rule

New 40 TAC §19.2801, restricting entry and requiring screening of certain authorized personnel at nursing facilities

CHAPTER 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATIONSUBCHAPTER CC. COVID-19 EMERGENCY RULE40 TAC §19.2801OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40, Texas Administrative Code, Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification, new Subchapter CC, COVID-19 Emergency Rule, §19.2801, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect nursing facility residents and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to restrict entry into a nursing facility and require screening of certain persons authorized to enter a nursing facility.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Facility Response to COVID-19.As authorized by Government Code §2001.034 the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Department on Aging and Disability Services

Emergency Rule

New 40 TAC §98.65, restricting entry and requiring screening of certain authorized personnel at day and health services facilities

CHAPTER 98. DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTSSUBCHAPTER D. LICENSURE AND PROGRAM REQUIREMENTS40 TAC §98.65OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40, Texas Administrative Code, Chapter 98 Day Activity and Health Services Requirements, new §98.65, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect day activity and health services clients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to restrict entry into a day and health services facility and require screening of certain persons authorized to enter a day and health services facility.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Day Activity and Health Services Response to COVID-19.As authorized by Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034, may be effective for not longer than 120 days and may be renewed for not longer than 60 days.


Texas Council for Developmental Disabilities

In Addition

Council requests applications for funding of new initiatives to support aging individuals with intellectual and developmental disabilities and their caregivers

OVERVIEWThe Texas Council for Developmental Disabilities (TCDD) announces the availability of funds for organizations to develop new initiatives to support people with intellectual and developmental disabilities (IDD) who are aging and their caregivers. As this population continues to grow, our system must be better-equipped to serve their unique needs during this life stage by providing information, resources, and support. Individual projects may focus primarily on meeting the needs of people with IDD who are aging, meeting the needs of aging caregivers of family members with IDD, and/or reducing gaps in the long-term services and supports system for people with IDD who are aging.FUNDINGTCDD has approved funding for up to two projects for up to $175,000 per organization, per year, for up to five years. Funds available for these projects are provided to TCDD by the U.S. Department of Health and Human Services, Administration on Disabilities, pursuant to the Developmental Disabilities Assistance and Bill of Rights Act. Funding for the projects is dependent on the results of a review process established by TCDD and on the availability of funds. Non-federal matching funds of at least 10% of the total project costs are required for projects in federally designated poverty areas. Non-federal matching funds of at least 25% of total project costs are required for projects in other areas.APPLICATION PROCESSAdditional information concerning this Request for Applications (RFA) and TCDD is available at https://tcdd.texas.gov/grants-rfas/funding-available-for-grants/. All questions pertaining to this RFA should be directed in writing to TCDD via email at apply@tcdd.texas.gov or via telephone at (512) 437-5432.Deadline: Applications must be submitted by 11:59 p.m. CT on Thursday, June 25, 2020. Applications will not be accepted after the due date.

Texas Health and Human Services Commission

In Addition

Amendment to the Texas Healthcare Transformation Quality Improvement Program (THTQIP) Waiver affecting certain children in Department of Family and Protective Services conservatorship

OVERVIEWThe Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) for an amendment to the Texas Healthcare Transformation Quality Improvement Program (THTQIP) waiver under section 1115 of the Social Security Act. CMS has approved this waiver through September 30, 2022.Effective September 1, 2020, the waiver amendment proposed by HHSC will allow children in AA and PCA Medicaid who are in a 1915(c) waiver, have SSI, and children who lose their SSI, to have the choice of staying in STAR Health or moving to STAR Kids when they leave conservatorship, instead of being required to go to STAR Kids or STAR.BACKGROUND AND JUSTIFICATIONCurrently, children in Department of Family and Protective Services (DFPS) conservatorship who have Supplemental Security Income (SSI) and who become eligible for Adoption Assistance (AA) or Permanency Care Assistance (PCA) are eligible to receive Medicaid benefits. However, these children may lose their SSI, because the adoptive or permanency care placement family does not meet SSI financial requirements. This loss of SSI results in the child enrolling into the STAR Medicaid managed care program, a program they otherwise would not have been eligible for. This amendment proposes to address this issue.AMENDMENT SUMMARYThe amendment is in response to House Bill 72 (86th Regular Session), codified in Government Code section 533.00531, concerning Medicaid benefits for children formerly in foster care, which requires the following:Allow children receiving Supplemental Security Income (SSI) or who were receiving Supplemental Security Income before becoming eligible for AA or PCA to continue to receive assistance or services under STAR Health or STAR Kids.HHSC must protect the continuity of care for each child in AA or PCA who have or had SSI and ensure coordination between the STAR Health program and any other Medicaid managed care program for each child who is transitioning between Medicaid managed care programs.


Texas Department of State Health Services

In Addition

DSHS has published an updated Asbestos Penalty Matrix

OVERVIEWThe Department of State Health Services (DSHS) has a published an updated Asbestos Penalty Matrix in accordance with the Texas Asbestos Health Protection Act (TAHPA). The updated matrix is published in this week’s edition of the Texas Register and shall be effective immediately upon publication in the Texas Register and shall supersede the current department procedures for assessing administrative penalties for violations of the TAHPR.BACKGROUND AND JUSTIFICATIONDSHS publishes the Asbestos Penalty Matrix (matrix) to inform the public and the regulated asbestos industry about the department’s enforcement policies. The penalties set forth in the matrix are created to promote compliance with the TAHPA and department rules, promote public confidence in the asbestos industry, and deter conduct detrimental to the health and safety of the public by ensuring consistent, uniform, and fair assessment of penalties by the department for violations of the TAHPR. The matrix promotes transparency in the department’s regulatory efforts to protect the public from asbestos emissions and provides notice of these regulatory standards to the public and the regulated asbestos industry. The list of violations in the matrix provides a corresponding citation to the appropriate section of the asbestos rules or the NESHAP, if applicable, for each violation.


Texas Department of Insurance

In Addition

Three Health Maintenance Organizations have applied for company licensing in Texas

Application to do business in the state of Texas for Provider Partners Health Plan, Inc., a foreign health maintenance organization (HMO). The home office is in Linthicum Heights, Maryland.Application for United Dental Care of Texas, a domestic health maintenance organization (HMO), DBA (doing business as) Sun Life. The home office is in Plano, Texas.Application for United Dental Care of Texas, a domestic health maintenance organization (HMO), DBA (doing business as) Sun Life Financial. The home office is in Plano, Texas.Any objections must be filed with the Texas Department of Insurance, within twenty (20) calendar days from the date of the Texas Register publication, addressed to the attention of Robert Rudnai, 333 Guadalupe Street, MC 103-CL, Austin, Texas 78701.


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